We propose a one year pilot study to develop and test a novel household safety survey tool for use in the home healthcare setting. A simple-to-use household safety survey tool can provide the basis for hazard identification and this information can serve to guide the development of targeted risk reduction interventions. Although unsafe conditions in the home care setting have the potential to adversely affect the delivery and quality of patient care, as well as the health and safety of patients and home health care workers, data on this issue are exceptionally sparse. With almost eight million patients currently enrolled in formal home care and an anticipated 47% growth by 2014, the patient population potentially at risk from household-related hazards is large and rapidly growing. Most home care patients are elderly (70% are 65 years of age or older) and increasingly have multiple diagnoses. Data from our recent occupational health hazards study involving over 1500 home care paraprofessionals and 700 home care registered nurses in New York State indicate high prevalence rates of certain household-related hazards. Many of these hazards present considerable risk of injury or illness to both patients and home care workers. This study, which represents a collaborative effort between the research team, Visiting Nurse Service of New York and 1199SEIU, will be conducted with the active participation of frontline workers. Guided by a participatory action research framework, home healthcare aides will help to develop and field test the safety survey tool. The proposed study will serve as an important first step in reducing the risk of injury and illness related to household hazards in the homecare sector. This application and builds upon and extends the current research trajectory of the Principal Investigator.